BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ACCU-CHEK COMFORT CURVE TEST STRIPS

    MDR report key: 1181583 · Received September 25, 2008

    Report

    Report Number
    1823260-2008-07176
    Event Type
    Malfunction
    Date Received
    September 25, 2008
    Date of Event
    September 20, 2008
    Report Date
    September 25, 2008
    Manufacturer
    ROCHE DIAGNOSTICS
    Product Code
    LFR
    PMA / PMN Number
    K010362
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    LAY USER/PATIENT

    Narratives

    Description of Event or Problem · 1

    REPORTER ALLEGED OBTAINING DISCREPANT BACK TO BACK BLOOD GLUCOSE RESULTS OF 271 MG/DL, 107 MG/DL AND 119 MG/DL WHEN ALL TEST WERE PERFORMED WITHIN 10 MINUTES ON THE ADVANTAGE SYSTEM. REPORTER INDICATED THAT HE WAS NOT EXPERIENCING ANY HYPOGLYCEMIC OR HYPERGLYCEMIC SYMPTOMS DURING THE TIME OF TESTING. NO ACTIONS WERE REPORTED TAKEN OR TREATMENT RECEIVED. NO ADVERSE EVENT REPORTED. A REQUEST WAS MADE FOR THE RETURN OF THE SUSPECT DEVICE AND REPLACEMENT PRODUCT WAS SENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ACCU-CHEK COMFORT CURVE TEST STRIPS BLOOD GLUCOSE MONITORING TEST STRIPS - LFR LFR ROCHE DIAGNOSTICS 550754

    Patients

    Seq Age Sex Outcome Treatment
    1 38 YR NIASPAN - 500MG TWICE DAILY| LANTUS - 30 UNITS DAILY| RANITIDINE - 150MG DAILY| "CITALOPRAM" - 20 MG DAILY| TRICOR - 145G DAILY| PREVACID - 30MG DAILY| LISINOPRIL - 2.5MG DAILY| VIAGRA - AS NEEDED